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Female Vag. Infect.
Female Vaginal Infections Differential Diagnosis
| Question | Answer |
|---|---|
| Vaginal infections often produce a discharge | Vaginal infections |
| Increase in discharge; clear or mucoid discharge; pH<4.5; | Physiologic vaginitis |
| Diagnostic Tests - wet mount; up to 3 to 5 WBCs; epithelial cells | Physiologic vaginitis |
| No foul odor, itching or edema; foul-smelling discharge; complains of "fishy odor"; homogenous thin, white or gray discharge; pH<4.5 | Bacterial vaginosis (Gardnerella vaginalis) |
| Diagnostic Tests - + KOH "whiff" test; wet mount: + clue cells | Bacterial vaginosis |
| Pruritic discharge; itching of labia; itching may extend to thighs; white, curdy discharge; pH 4.0 to 5.0; cervix may be red; may have erythema of perineum and thighs | Candida vulvovaginitis (Candida albicans) |
| Diagnostic Tests - KOH prep; mycelia budding, branching yeast, pseudohyphae | Candida vulvovaginitis |
| Watery discharge; foul odor; dysuria and dyspareunia with severe infection; profuse, frothy, greenish discharge; pH 5.0 to 6.6; red friable cervix with petechia (strawberry cervix) | Trichomoniasis (Trichomonas vaginalis) |
| Diagnostic Tests - West mount; round or pear shaped protozoa; motile "gyrating" flagella | Trichomoniasis |
| Partner with STI; often asymptomatic or may have symptoms of PID; purulent discharge from cervix; Skene/Bartholin gland inflammation; cervix and vulva may be inflammed | Gonorrhea (Neisseria gonorrhoeae) |
| Diagnostic Tests - Gram stain; culture; DNA probe | Gonorrhea |
| Partner with nongonococcal urethritis; often asymptomatic; may complain of spotting after intercourse or urethritis; +/- purulent discharge; cervix may or may not be red or friable | Chlamydia (Chlamydia tachomatis) |
| Diagnostic Tests - DNA probe | Chlamydia |
| Dyspareunia; vaginal dryness; perimenopausal or postmenopausal; pale, thin vaginal mucosa; pH<4.5 | Atrophic vaginitis |
| Diagnostic Tests - Wet mount; folded, clumped epithelial cells | Atrophic vaginitis |
| New bubble bath, soap, douche, or other hygiene products; foul smell; erythema; pH<4.5 | Allergic vaginitis |
| Diagnostic tests - Wet mount: WBC's | Allergic vaginitis |
| Red and swollen vulva; vaginal discharge; history of use of tampon, condom, or diaphragm; bloody or foul-smelling discharge | Foreign Body |
| Diagnostic Tests - wet mount: WBCs | Foreign Body |
Created by:
schnackerfarm
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